This is also known as Pelvic Organ Prolapse (POP). It consists of the descent of a pelvic organ into or beyond the vagina, perineum or anal canal. When the bladder has prolapsed into the vagina, there is anterior wall prolapse and it is called cystocele. If the urethra has prolapsed into the vagina it is known as urethrocele. When the rectum prolapses into the vagina it is called a rectocele. If the bowel has prolapsed into the vagina this is known as enterocele. These two are posterior to the vagina, so they are considered posterior wall prolapse.
The descent of the uterus is termed uterine prolapse and if the vaginal cuff is descended (in the absence of a uterus), it is termed vaginal vault prolapse. These two are considered apical prolapse. Based on the degree of descent the prolapse can be grade 1,2, 3 or 4. This condition is more prevalent after the age of 80. The chances of a woman having prolapse after menopause is in the range of 30-50%. The risk is increased by a large number of deliveries, especially difficult vaginal deliveries.
Obesity is a risk factor, so is also chronic constipation. It is caused by weak pelvic muscles and straining or strenuous lifting can aggravate the condition. In some cases incontinence can be encountered. Sexual dysfunction can also be seen. After examination and evaluation strengthening Kegel’s exercises are recommended and in some cases a pessary can be beneficial. If there is vaginal atrophy an estrogen cream is helpful. About 10% of cases are treated with surgery.